Introduction Assessment of hemodynamics is an important skill in the critical care setting. The goal of hemodynamic monitoring in a critically ill patient is to ensure adequate tissue oxygen delivery and end-organ perfusion. Low systemic arterial blood pressures are commonly…
Hypertensive emergency (HE) is a severe elevation in systemic blood pressure combined with new or progressive end-organ damage most frequently in the cardiac, renal, and central nervous systems. HE is an infrequent clinical presentation of acute hypertension that requires immediate,…
“Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever.” William Osler, from his address to the 47th annual meeting of the American Medical Association, 1896 Fever…
Introduction Pain management in the critically ill patient is complex. Each patient brings a unique set of sociodemographic, pharmacokinetic, and pharmacogenomic variables that are coupled with underlying psychosocial and medical comorbidities. These not only influence a patient’s response to painful…
Agitation and delirium are commonly encountered in the intensive care unit (ICU). Although frequently underrecognized, delirium is present in up to 80% of critically ill adults on mechanical ventilation when routinely assessed. Delirium and agitation are more than just an…
Patients admitted to the intensive care unit (ICU) with critical illness or injury are at risk for neurologic complications. A sudden or unexpected change in the neurologic condition of a critically ill patient often heralds a complication that may cause…
It is not entirely clear how a chapter on pregnancy fits into a book titled Anesthesia and Coexisting Disease . Pregnancy is not a disease, but a normal physiologic condition, usually associated with and dependent on relatively good health. For…
Unique considerations in pediatric patients When it comes to anesthetic care, children are not merely small adults. Many considerations come into play beyond underlying medical conditions: the child’s age, developmental stage (physically and psychologically), physiology, social circumstances, and family factors…
Introduction Compared to 100 years ago, people are living much longer. The US life expectancy for men in 1900 was 48 years and for women, 51 years. Currently the average life expectancy in the United States exceeds 75 years. The…
The prevalence of mental illness and substance use disorders in the United States is about 30%, so these conditions are often present in patients undergoing anesthesia and surgery. Effects of and potential drug interactions with psychotropic medications are important perioperative…